Pub Date : 2023-09-01Epub Date: 2022-04-26DOI: 10.1017/BrImp.2022.7
Henk J Eilander, Willemijn S van Erp, Daniëlle M F Driessen, Berno U H Overbeek, Jan C M Lavrijsen
Objective: To present an updated version of the 'Post-acute Level Of Consciousness scale' (PALOC-s), in accordance with the latest scientific insights.
Methods: Within the context of a research project, 20 years ago, the PALOC-s was developed for the purpose of following the development of the level of consciousness of young unconscious patients participating in a rehabilitation program. Meanwhile, the understanding of the behavior related to different levels of consciousness has developed and terminology has changed, resulting in the need to revise the PALOC-s. With the preservation of the original description of the eight hierarchical levels of PALOC-s, adaptations are made in the terminology and grouping of these levels.
Results and conclusion: This manuscript presents the revised version of PALOC-sr, which is suitable for use in clinical practice. The validation of this scale is recommended for its optimal use in future (international) research projects.
{"title":"Post-Acute Level Of Consciousness scale revised (PALOC-sr): adaptation of a scale for classifying the level of consciousness in patients with a prolonged disorder of consciousness.","authors":"Henk J Eilander, Willemijn S van Erp, Daniëlle M F Driessen, Berno U H Overbeek, Jan C M Lavrijsen","doi":"10.1017/BrImp.2022.7","DOIUrl":"10.1017/BrImp.2022.7","url":null,"abstract":"<p><strong>Objective: </strong>To present an updated version of the 'Post-acute Level Of Consciousness scale' (PALOC-s), in accordance with the latest scientific insights.</p><p><strong>Methods: </strong>Within the context of a research project, 20 years ago, the PALOC-s was developed for the purpose of following the development of the level of consciousness of young unconscious patients participating in a rehabilitation program. Meanwhile, the understanding of the behavior related to different levels of consciousness has developed and terminology has changed, resulting in the need to revise the PALOC-s. With the preservation of the original description of the eight hierarchical levels of PALOC-s, adaptations are made in the terminology and grouping of these levels.</p><p><strong>Results and conclusion: </strong>This manuscript presents the revised version of PALOC-sr, which is suitable for use in clinical practice. The validation of this scale is recommended for its optimal use in future (international) research projects.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85282197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2022-05-05DOI: 10.1017/BrImp.2022.13
Kate Rachel Gould, Matthew Carolan, Jennie Louise Ponsford
Cyberscams, such as romance scams, are prevalent and costly online hazards in the general community. People with Acquired Brain Injury (ABI) may be particularly vulnerable and have greater difficulty recovering from the resultant emotional and financial hardships. In order to build capacity in the neurorehabilitation sector, it is necessary to determine whether clinicians currently encounter this issue and what prevention and intervention approaches have been found effective. This scoping study aimed to explore clinicians' exposure to and experiences with cyberscams in their adult clients with ABI.
Method: Participants were clinicians recruited from multidisciplinary networks across Australia and New Zealand. Eligible participants (n = 101) completed an online customised survey.
Results: More than half (53.46%) the participants had one or more clients affected by cyberscams, predominantly romance scams. Cognitive impairments and loneliness were reportedly associated with increased vulnerability. Cyberscams impacted treatment provision and were emotionally challenging for participants. No highly effective interventions were identified.
Conclusions: These findings indicate that cyberscams are a clinical issue relevant to neurorehabilitation providers, with prevalence studies now required. The lack of effective interventions identified underscores the need for the development of evidence-based prevention and treatment approaches to ultimately help people with ABI safely participate in online life.
网络诈骗(如恋爱诈骗)是普通社区普遍存在的网络危害,代价高昂。后天性脑损伤(ABI)患者可能特别容易受到网络诈骗的侵害,并且在情感和经济上更难恢复。为了提高神经康复部门的能力,有必要确定临床医生目前是否遇到过这一问题,以及哪些预防和干预方法是有效的。本范围界定研究旨在探讨临床医生在其患有 ABI 的成年客户中接触网络诈骗的情况和经历:参与者是从澳大利亚和新西兰的多学科网络中招募的临床医生。符合条件的参与者(n = 101)完成了一项在线定制调查:超过半数(53.46%)的参与者有一位或多位客户受到网络诈骗的影响,主要是恋爱诈骗。据报告,认知障碍和孤独感与易受害性增加有关。网络诈骗影响了治疗的提供,并对参与者的情绪造成挑战。没有发现非常有效的干预措施:这些研究结果表明,网络诈骗是一个与神经康复服务提供者相关的临床问题,现在需要进行流行率研究。由于缺乏有效的干预措施,因此需要开发以证据为基础的预防和治疗方法,最终帮助有损伤的患者安全地参与网络生活。
{"title":"Do we need to know about cyberscams in neurorehabilitation? A cross-sectional scoping survey of Australasian clinicians and service providers.","authors":"Kate Rachel Gould, Matthew Carolan, Jennie Louise Ponsford","doi":"10.1017/BrImp.2022.13","DOIUrl":"10.1017/BrImp.2022.13","url":null,"abstract":"<p><p>Cyberscams, such as romance scams, are prevalent and costly online hazards in the general community. People with Acquired Brain Injury (ABI) may be particularly vulnerable and have greater difficulty recovering from the resultant emotional and financial hardships. In order to build capacity in the neurorehabilitation sector, it is necessary to determine whether clinicians currently encounter this issue and what prevention and intervention approaches have been found effective. This scoping study aimed to explore clinicians' exposure to and experiences with cyberscams in their adult clients with ABI.</p><p><strong>Method: </strong>Participants were clinicians recruited from multidisciplinary networks across Australia and New Zealand. Eligible participants (<i>n</i> = 101) completed an online customised survey.</p><p><strong>Results: </strong>More than half (53.46%) the participants had one or more clients affected by cyberscams, predominantly romance scams. Cognitive impairments and loneliness were reportedly associated with increased vulnerability. Cyberscams impacted treatment provision and were emotionally challenging for participants. No highly effective interventions were identified.</p><p><strong>Conclusions: </strong>These findings indicate that cyberscams are a clinical issue relevant to neurorehabilitation providers, with prevalence studies now required. The lack of effective interventions identified underscores the need for the development of evidence-based prevention and treatment approaches to ultimately help people with ABI safely participate in online life.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82196773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-02-20DOI: 10.1017/BrImp.2023.4
Emily Ong, Dennis Frost, Saskia Kuliga, Natasha Layton, Jacki Liddle
The environment, and assistive technologies as part of this, can play an important role in supporting the participation and wellbeing of people living with dementia. If not considered, environments can be overwhelming and disempowering. Disability approaches including environmental considerations and assistive technology were often not offered routinely with people living with dementia. Concerned by this, dementia advocates aimed to create change in this area. The Environmental Design-Special Interest Group (ED-SiG) of Dementia Alliance International was developed as an international consumer-driven community of practice bringing together people with different relevant expertise including living experience (people living with dementia, care partners), architecture and design, occupational therapy, rehabilitation and care provision. This practice opinion piece provides an overview of dementia, the need for collaborative practices within practice with people living with dementia, and the considerations of assistive technology, environmental design and the global context. The reflection provides insights into this international community of practice, with personal reflections of members with living experience of dementia, and benefits and opportunities in considering environmental design and assistive technology from the perspectives of members. This work demonstrates and advocates collaborations that centre the perspectives and expertise of people living with dementia.
{"title":"Creating a consumer-driven global community of practice to support action within environmental design with people living with dementia: assistive technology challenges and opportunities.","authors":"Emily Ong, Dennis Frost, Saskia Kuliga, Natasha Layton, Jacki Liddle","doi":"10.1017/BrImp.2023.4","DOIUrl":"10.1017/BrImp.2023.4","url":null,"abstract":"<p><p>The environment, and assistive technologies as part of this, can play an important role in supporting the participation and wellbeing of people living with dementia. If not considered, environments can be overwhelming and disempowering. Disability approaches including environmental considerations and assistive technology were often not offered routinely with people living with dementia. Concerned by this, dementia advocates aimed to create change in this area. The Environmental Design-Special Interest Group (ED-SiG) of Dementia Alliance International was developed as an international consumer-driven community of practice bringing together people with different relevant expertise including living experience (people living with dementia, care partners), architecture and design, occupational therapy, rehabilitation and care provision. This practice opinion piece provides an overview of dementia, the need for collaborative practices within practice with people living with dementia, and the considerations of assistive technology, environmental design and the global context. The reflection provides insights into this international community of practice, with personal reflections of members with living experience of dementia, and benefits and opportunities in considering environmental design and assistive technology from the perspectives of members. This work demonstrates and advocates collaborations that centre the perspectives and expertise of people living with dementia.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89123545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How is assistive technology meeting the needs and goals of people with brain impairment? Building evidence to support practice.","authors":"Libby Callaway, Jacki Liddle","doi":"10.1071/IB23030","DOIUrl":"10.1071/IB23030","url":null,"abstract":"","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2021-10-04DOI: 10.1017/BrImp.2021.15
Emily M Norman, Nicola J Starkey, Devon L L Polaschek
Background: Traumatic brain injury is overrepresented in incarcerated samples and has been linked to a number of poor correctional outcomes. Despite this, no research has explored the impact of a recent TBI on compliance outcomes for individuals serving community-based.
Method: We screened for a history of TBI in 106 adults on community sentences and collected compliance (arrests, sentence violations) and related variables (e.g., risk scores, substance use) over 6 months. Sixty-four participants also completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Comprehensive Trail Making Test and Color-Word Inference Test.
Results: A TBI in the last year predicted a significantly higher likelihood of arrest, even when controlling for risk of reconviction and current substance use, but was not associated with non-compliance with sentence conditions nor with performance on the neuropsychological tests. In addition, no significant associations were found between performance on neuropsychological tests and measures of non-compliance.
Conclusions: TBI in the last year was an independent predictor of arrest. This result suggests that those with a recent TBI on a community sentence may need additional monitoring or support to reduce the risk of reoffending.
{"title":"The association between self-reported traumatic brain injury, neuropsychological function, and compliance among people serving community sentences.","authors":"Emily M Norman, Nicola J Starkey, Devon L L Polaschek","doi":"10.1017/BrImp.2021.15","DOIUrl":"10.1017/BrImp.2021.15","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury is overrepresented in incarcerated samples and has been linked to a number of poor correctional outcomes. Despite this, no research has explored the impact of a recent TBI on compliance outcomes for individuals serving community-based.</p><p><strong>Method: </strong>We screened for a history of TBI in 106 adults on community sentences and collected compliance (arrests, sentence violations) and related variables (e.g., risk scores, substance use) over 6 months. Sixty-four participants also completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Comprehensive Trail Making Test and Color-Word Inference Test.</p><p><strong>Results: </strong>A TBI in the last year predicted a significantly higher likelihood of arrest, even when controlling for risk of reconviction and current substance use, but was not associated with non-compliance with sentence conditions nor with performance on the neuropsychological tests. In addition, no significant associations were found between performance on neuropsychological tests and measures of non-compliance.</p><p><strong>Conclusions: </strong>TBI in the last year was an independent predictor of arrest. This result suggests that those with a recent TBI on a community sentence may need additional monitoring or support to reduce the risk of reoffending.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82667749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2022-02-14DOI: 10.1017/BrImp.2021.38
James R Gooden, Catherine A Cox, Vanessa Petersen, Ashlee Curtis, Paul G Sanfilippo, Victoria Manning, Georgia L Bolt, Dan I Lubman
Introduction: Cognitive impairment is common in individuals presenting to alcohol and other drug (AOD) settings and the presence of biopsychosocial complexity and health inequities can complicate the experience of symptoms and access to treatment services. A challenge for neuropsychologists in these settings is to evaluate the likely individual contribution of these factors to cognition when providing an opinion regarding diagnoses such as acquired brain injury (ABI). This study therefore aimed to identify predictors of cognitive functioning in AOD clients attending for neuropsychological assessment.
Methods: Clinical data from 200 clients with AOD histories who attended for assessment between 2014 and 2018 were analysed and a series of multiple regressions were conducted to explore predictors of cognitive impairment including demographic, diagnostic, substance use, medication, and mental health variables.
Results: Regression modelling identified age, gender, years of education, age of first use, days of abstinence, sedative load, emotional distress and diagnoses of ABI and developmental disorders as contributing to aspects of neuropsychological functioning. Significant models were obtained for verbal intellectual functioning (Adj R2 = 0.19), nonverbal intellectual functioning (Adj R2 = 0.10), information processing speed (Adj R2 = 0.20), working memory (Adj R2 = 0.05), verbal recall (Adj R2 = 0.08), visual recall (Adj R2 = 0.22), divided attention (Adj R2 = 0.14), and cognitive inhibition (Adj R2 = 0.07).
Conclusions: These findings highlight the importance of careful provision of diagnoses in clients with AOD histories who have high levels of unmet clinical needs. They demonstrate the interaction of premorbid and potentially modifiable comorbid factors such as emotional distress and prescription medication on cognition. Ensuring that modifiable risk factors for cognitive impairment are managed may reduce experiences of cognitive impairment and improve diagnostic clarity.
{"title":"Predictors of cognitive functioning in presentations to a community-based specialist addiction neuropsychology service.","authors":"James R Gooden, Catherine A Cox, Vanessa Petersen, Ashlee Curtis, Paul G Sanfilippo, Victoria Manning, Georgia L Bolt, Dan I Lubman","doi":"10.1017/BrImp.2021.38","DOIUrl":"10.1017/BrImp.2021.38","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive impairment is common in individuals presenting to alcohol and other drug (AOD) settings and the presence of biopsychosocial complexity and health inequities can complicate the experience of symptoms and access to treatment services. A challenge for neuropsychologists in these settings is to evaluate the likely individual contribution of these factors to cognition when providing an opinion regarding diagnoses such as acquired brain injury (ABI). This study therefore aimed to identify predictors of cognitive functioning in AOD clients attending for neuropsychological assessment.</p><p><strong>Methods: </strong>Clinical data from 200 clients with AOD histories who attended for assessment between 2014 and 2018 were analysed and a series of multiple regressions were conducted to explore predictors of cognitive impairment including demographic, diagnostic, substance use, medication, and mental health variables.</p><p><strong>Results: </strong>Regression modelling identified age, gender, years of education, age of first use, days of abstinence, sedative load, emotional distress and diagnoses of ABI and developmental disorders as contributing to aspects of neuropsychological functioning. Significant models were obtained for verbal intellectual functioning (Adj R<sup>2</sup> = 0.19), nonverbal intellectual functioning (Adj R<sup>2</sup> = 0.10), information processing speed (Adj R<sup>2</sup> = 0.20), working memory (Adj R<sup>2</sup> = 0.05), verbal recall (Adj R<sup>2</sup> = 0.08), visual recall (Adj R<sup>2</sup> = 0.22), divided attention (Adj R<sup>2</sup> = 0.14), and cognitive inhibition (Adj R<sup>2</sup> = 0.07).</p><p><strong>Conclusions: </strong>These findings highlight the importance of careful provision of diagnoses in clients with AOD histories who have high levels of unmet clinical needs. They demonstrate the interaction of premorbid and potentially modifiable comorbid factors such as emotional distress and prescription medication on cognition. Ensuring that modifiable risk factors for cognitive impairment are managed may reduce experiences of cognitive impairment and improve diagnostic clarity.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80403834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2022-04-19DOI: 10.1017/BrImp.2022.2
Karen A Sullivan, Kannan Singaravelu Jaganathan, Sally Kinmond
Objective: Athletes perceive sports fans as a source of concussion nondisclosure pressure. Sports fans are exposed to injury depictions from the media that could lead them to underestimate its seriousness. This study examined the concussion knowledge of non-sports fans, sports fans, and wagering sports fans, as knowledge is a modifiable factor that can influence injury disclosure.
Setting and participants: A convenience sample of 443 Australian adults completed an online survey.
Design: Cross-sectional.
Main measures: Self-rated and actual concussion knowledge (the Rosenbaum Concussion Knowledge and Attitudes Survey; RoCKAS).
Results: There was no significant difference in the concussion knowledge of self-identified sports (n = 157) and non-sports (n = 286) fans; but sports fans rated their knowledge as significantly higher than non-sports fans (p < .05). Wagering sports fans (n = 24) had significantly less concussion knowledge than non-wagering sports fans (η2 = .03, small effect).
Discussion: Athletes who feel nondisclosure pressure from sports fans may be influenced by people with incomplete concussion knowledge, particularly wagering sports fans. Sports fans over-estimated their knowledge, and this could contribute to the nondisclosure pressure felt by athletes. Programmes to increase injury disclosure by athletes should take these factors into consideration.
{"title":"Sports fans, wagering, and concussion knowledge: implications for injury nondisclosure.","authors":"Karen A Sullivan, Kannan Singaravelu Jaganathan, Sally Kinmond","doi":"10.1017/BrImp.2022.2","DOIUrl":"10.1017/BrImp.2022.2","url":null,"abstract":"<p><strong>Objective: </strong>Athletes perceive sports fans as a source of concussion nondisclosure pressure. Sports fans are exposed to injury depictions from the media that could lead them to underestimate its seriousness. This study examined the concussion knowledge of non-sports fans, sports fans, and wagering sports fans, as knowledge is a modifiable factor that can influence injury disclosure.</p><p><strong>Setting and participants: </strong>A convenience sample of 443 Australian adults completed an online survey.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Main measures: </strong>Self-rated and actual concussion knowledge (the Rosenbaum Concussion Knowledge and Attitudes Survey; RoCKAS).</p><p><strong>Results: </strong>There was no significant difference in the concussion knowledge of self-identified sports (<i>n</i> = 157) and non-sports (<i>n</i> = 286) fans; but sports fans rated their knowledge as significantly higher than non-sports fans (<i>p</i> < .05). Wagering sports fans (<i>n</i> = 24) had significantly less concussion knowledge than non-wagering sports fans (η<sup>2</sup> = .03, small effect).</p><p><strong>Discussion: </strong>Athletes who feel nondisclosure pressure from sports fans may be influenced by people with incomplete concussion knowledge, particularly wagering sports fans. Sports fans over-estimated their knowledge, and this could contribute to the nondisclosure pressure felt by athletes. Programmes to increase injury disclosure by athletes should take these factors into consideration.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76867463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2022-04-19DOI: 10.1017/BrImp.2022.3
Elizabeth O'Shannessy, Sandra Reeder, Swarna Vishwanath, Sophie Hill, Andrew Perta, Laura Jolliffe, Jacqui Morarty, Peter Hunter, Natasha A Lannin
Background and aim: Rehabilitation therapy is a key part of the recovery pathway for people with severe acquired brain injury (ABI). The aim of this study was to explore inpatients' and their family members' experiences of a specialist ABI rehabilitation service.
Methods: A cross sectional, prospective mixed method study was undertaken at a metropolitan specialist ABI rehabilitation unit in Victoria, Australia. All inpatients and their family members of the service were invited to complete a satisfaction survey. Employing purposive sampling, semi-structured interviews were conducted with inpatients and/or their family members.
Results: In total, 111 people completed the satisfaction survey and 13 were interviewed. High levels of satisfaction with the specialist service were reported; the majority of inpatients (74%) and family members (81%) rated the overall quality of care received in the service as 'high' or 'very high'. Interviews revealed four main themes: (i) satisfaction with rehabilitation services, (ii) inconsistent communication, (iii) variable nursing care, and (iv) strengths and weakness of the rehabilitation environment. Overall, important components of a positive experience were being involved in decision making and discharge planning, effective communication and information processes, and being able to form therapeutic relationships with staff. Key sources of dissatisfaction for inpatients and family members related to inconsistency in care, accessing information about treatments in a format easily understood, and communication.
Conclusion: Specialised rehabilitation is valued by inpatients and their family members alike. The findings highlight the importance of exploring inpatient experiences to optimise service delivery in a tailored, specialised rehabilitation programme.
{"title":"Mixed methods study to understand the experiences of adults with acquired brain injury and their family members who receive specialised rehabilitation.","authors":"Elizabeth O'Shannessy, Sandra Reeder, Swarna Vishwanath, Sophie Hill, Andrew Perta, Laura Jolliffe, Jacqui Morarty, Peter Hunter, Natasha A Lannin","doi":"10.1017/BrImp.2022.3","DOIUrl":"10.1017/BrImp.2022.3","url":null,"abstract":"<p><strong>Background and aim: </strong>Rehabilitation therapy is a key part of the recovery pathway for people with severe acquired brain injury (ABI). The aim of this study was to explore inpatients' and their family members' experiences of a specialist ABI rehabilitation service.</p><p><strong>Methods: </strong>A cross sectional, prospective mixed method study was undertaken at a metropolitan specialist ABI rehabilitation unit in Victoria, Australia. All inpatients and their family members of the service were invited to complete a satisfaction survey. Employing purposive sampling, semi-structured interviews were conducted with inpatients and/or their family members.</p><p><strong>Results: </strong>In total, 111 people completed the satisfaction survey and 13 were interviewed. High levels of satisfaction with the specialist service were reported; the majority of inpatients (74%) and family members (81%) rated the overall quality of care received in the service as 'high' or 'very high'. Interviews revealed four main themes: (i) satisfaction with rehabilitation services, (ii) inconsistent communication, (iii) variable nursing care, and (iv) strengths and weakness of the rehabilitation environment. Overall, important components of a positive experience were being involved in decision making and discharge planning, effective communication and information processes, and being able to form therapeutic relationships with staff. Key sources of dissatisfaction for inpatients and family members related to inconsistency in care, accessing information about treatments in a format easily understood, and communication.</p><p><strong>Conclusion: </strong>Specialised rehabilitation is valued by inpatients and their family members alike. The findings highlight the importance of exploring inpatient experiences to optimise service delivery in a tailored, specialised rehabilitation programme.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79810499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2022-04-18DOI: 10.1017/BrImp.2021.33
Kirstyn Laurie, Michele Foster, Louise Gustafsson
People with an acquired brain injury (ABI) experience substantial access inequalities and unmet health needs, with many experiencing insufficient access to appropriate rehabilitation in the community. To deepen our understanding of what appropriate access to post-acute care services is for this population, and to facilitate optimal recovery, there is a need to synthesise research from the service user perspective. A scoping review study was conducted to identify key characteristics of 'appropriate' access to post-acute care services, as defined by the personal experiences of adults with ABI. Electronic scientific databases Medline, PsycINFO, Proquest Central and CINAHL were searched for studies published between 2000 and 2020. The initial search identified 361 articles which, along with articles retrieved from reference list searches, resulted in 52 articles included in the final analysis. Results indicated that a majority of the studies sampled participants with an average of over 1 year post-injury, with some studies sampling participants ranging over 10 years in difference in time post-injury. A thematic synthesis was conducted and results indicated a number of dominant elements which relate to (1) the characteristics of services: provider expertise, interpersonal qualities, partnership and adaptability; (2) characteristics of the health system: navigable system, integrated care, adequacy, and opportunity. These findings provide some insight into what might be considered appropriate. However, rigorous research, focused on personalised access to post-acute care services, is recommended to verify and elaborate on these findings.
{"title":"Personal experiences of appropriate access to post-acute care services in acquired brain injury: a scoping review.","authors":"Kirstyn Laurie, Michele Foster, Louise Gustafsson","doi":"10.1017/BrImp.2021.33","DOIUrl":"10.1017/BrImp.2021.33","url":null,"abstract":"<p><p>People with an acquired brain injury (ABI) experience substantial access inequalities and unmet health needs, with many experiencing insufficient access to appropriate rehabilitation in the community. To deepen our understanding of what appropriate access to post-acute care services is for this population, and to facilitate optimal recovery, there is a need to synthesise research from the service user perspective. A scoping review study was conducted to identify key characteristics of 'appropriate' access to post-acute care services, as defined by the personal experiences of adults with ABI. Electronic scientific databases Medline, PsycINFO, Proquest Central and CINAHL were searched for studies published between 2000 and 2020. The initial search identified 361 articles which, along with articles retrieved from reference list searches, resulted in 52 articles included in the final analysis. Results indicated that a majority of the studies sampled participants with an average of over 1 year post-injury, with some studies sampling participants ranging over 10 years in difference in time post-injury. A thematic synthesis was conducted and results indicated a number of dominant elements which relate to (1) the characteristics of services: provider expertise, interpersonal qualities, partnership and adaptability; (2) characteristics of the health system: navigable system, integrated care, adequacy, and opportunity. These findings provide some insight into what might be considered appropriate. However, rigorous research, focused on personalised access to post-acute care services, is recommended to verify and elaborate on these findings.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73730429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01Epub Date: 2021-12-15DOI: 10.1017/BrImp.2021.25
Laura J Smith, Polly Gregory, Philip Clatworthy, Lucy Gallop, George Stothart
Background: Transient ischaemic attack (TIA) can lead to lasting changes in brain structure and function resulting in cognitive impairment. Cognitive screening tools may lack sensitivity for detecting cognitive impairments, particularly executive function, which tends to be the earliest affected domain in vascular cognitive impairment.
Aim: In this preliminary study, we examine a working memory (WMem) task as a sensitive measure of cognitive impairment in TIA.
Method: Patients referred to a TIA clinic for transient neurological symptoms completed a general cognitive screening tool (Montreal Cognitive Assessment; MoCA), and a WMem task (2-N-back) in a cross-sectional design.
Results: TIA patients (n = 12) showed significantly reduced WMem performance on the N-back compared to patients diagnosed with mimic clinical conditions with overlapping symptoms (n = 16). No group differences were observed on the MoCA.
Conclusions: Assessing WMem may provide a sensitive measure of cognitive impairment after TIA, with implications for cognitive screening in TIA services to triage patients for further neuropsychological support, or for interventions to prevent vascular dementia.
背景:短暂性脑缺血发作(TIA)可导致大脑结构和功能的持久性改变,从而造成认知障碍。认知筛查工具可能缺乏检测认知障碍的灵敏度,尤其是执行功能,而执行功能往往是血管性认知障碍中最早受到影响的领域。目的:在这项初步研究中,我们将工作记忆(WMem)任务作为衡量 TIA 认知障碍的灵敏指标:因短暂性神经症状转诊至 TIA 诊所的患者在横断面设计中完成了一般认知筛查工具(蒙特利尔认知评估;MoCA)和工作记忆任务(2-N-back):TIA患者(12人)在N-back任务中的WMem表现明显低于症状重叠的模拟临床症状患者(16人)。在MoCA上没有观察到组间差异:评估WMem可以灵敏地测量TIA后的认知功能障碍,对TIA服务中的认知筛查具有重要意义,可将患者分流以获得进一步的神经心理学支持,或用于预防血管性痴呆的干预措施。
{"title":"Working Memory Impairment in Transient Ischaemic Attack: N-back as a Sensitive Measure for Detection.","authors":"Laura J Smith, Polly Gregory, Philip Clatworthy, Lucy Gallop, George Stothart","doi":"10.1017/BrImp.2021.25","DOIUrl":"10.1017/BrImp.2021.25","url":null,"abstract":"<p><strong>Background: </strong>Transient ischaemic attack (TIA) can lead to lasting changes in brain structure and function resulting in cognitive impairment. Cognitive screening tools may lack sensitivity for detecting cognitive impairments, particularly executive function, which tends to be the earliest affected domain in vascular cognitive impairment.</p><p><strong>Aim: </strong>In this preliminary study, we examine a working memory (WMem) task as a sensitive measure of cognitive impairment in TIA.</p><p><strong>Method: </strong>Patients referred to a TIA clinic for transient neurological symptoms completed a general cognitive screening tool (Montreal Cognitive Assessment; MoCA), and a WMem task (2-N-back) in a cross-sectional design.</p><p><strong>Results: </strong>TIA patients (n = 12) showed significantly reduced WMem performance on the N-back compared to patients diagnosed with mimic clinical conditions with overlapping symptoms (n = 16). No group differences were observed on the MoCA.</p><p><strong>Conclusions: </strong>Assessing WMem may provide a sensitive measure of cognitive impairment after TIA, with implications for cognitive screening in TIA services to triage patients for further neuropsychological support, or for interventions to prevent vascular dementia.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81077006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}